Withdrawal form

Complete and return this form only if you wish to withdraw from the contract

To,
Mofelito Paperito
Auguste Lambiottestraat 77
1030 Brussels
Belgium
+ 32 485 18 23 39
Email: [email protected]

I/We (*) hereby give notice that
I/We (*) withdraw from my/our (*)
contract of sale of the following goods (*)
/for the provision of the following service (*),

Name of consumer *
Name of consumer